1. Field of the Invention
This disclosure relates to systems for automatically assessing the likelihood that an individual observed by the system will suffer a fall while they are within a particular environment. Generally, the system will be used to assess the likelihood of a patient falling while in long term care or hospitalized.
2. Description of the Related Art
Watching a toddler learn to walk, one may find it difficult to believe that falling can be one of the most dangerous things that can happen to a human being. While children are known to fall down on what seems to be a near constant basis and generally jump right back up, as one ages the potential damage from a fall can go up dramatically.
When people discuss fall risk and the dangers of tails, they are generally talking about the risks for the elderly, which is a term commonly used to refer to those over age 65. That population is often much more susceptible to body damage from a fall and is more likely to suffer from falls as well. This population can be prone to increased falls from a myriad of problems such as worsening eyesight (e.g. due to issues such as presbyopia), decreases in muscle mass and reduced strength, and from taking medications which may induce dizziness or vertigo. Further this population is often more susceptible to damage from falls due to weakening of bones and lack of musculature which means that an impact from a fall is more likely to do more serious damage.
Falls in the elderly can be a substantial problem. It has been estimated that falls are the leading cause of both fatal and nonfatal injuries in the elderly and are one of the primary causes of broken bones (particularly hips) and head trauma. It has been estimated that 33% of the elderly will fall every year and that a third of those who fall will suffer moderate to severe injuries (or even death) because of the fall. This means that those who house or serve the elderly on a regular basis need to be constantly vigilant for the potential for falls.
Even outside of concerns about the elderly, falls can still present a major concern. This is particularly true in medical and hospital settings, in these settings, even normally able-bodied people can be susceptible to a dramatically increased risk of falls and the elderly (who often require more medical attention) can be particularly susceptible. Treatments and medications (most notably anesthetics and pain killers) used in medical settings can make patients dizzy, nauseous, or confused leading to them having a greatly heightened risk of falls. Further, injuries or symptoms which sent the person to the hospital in the first place (for example muscle weakness, damaged bones, or pain) can make a patient more susceptible to falls as well.
The susceptibility of the patient population to falls is also combined with institutional issues with hospitals and other medical facilities which can increase full risk and severity. Hospitals often have smooth surfaced, and very hard, floors for easy cleaning and disinfection, but this can also make them slippery. Further, hospital equipment is often bulky, but needs to be placed in close proximity to patient areas to make it accessible quickly which can reduce open areas and require more complicated navigation. Finally, since a hospital is generally a foreign environment to the patient, they are also susceptible to simple lack of familiarity and can misestimate the size and shape of steps or pathways resulting in a fall.
Falls for hospitalized patients are believed to present 30-40% of safety incidents within any hospital and will generally occur at a rate of 4-14 for every 1000 bed days at a hospital. For even a relatively small facility, this can lead to multiple fall incidents every month, and can make them a near daily occurrence for a large institution. The problem is exacerbated because falls are often seen as a preventable and, therefore, while they are very common injuries (and in some cases likely unavoidable), falls can result in punishment to the hospital in the form of reduced governmental recognition for quality of care and malpractice lawsuits.
To try and reduce the risk and severity of falls in the hospital setting, and in facilities such as nursing and retirement homes with a predominantly elderly population, many facilities utilize a variety of fall risk assessment tools to try and determine a risk factor for a particular patient to fall while they are within the facility. In most cases, these relate to a patient's answers on various forms of questionnaire and observations of facility personnel on the behavior of the patient. These systems are known to suffer from a myriad of problems.
In the first instance, most current fall risk assessments are subjective and may rely on flawed perceptions about the person's risk of a fall. Secondly, they are often assessed only on certain known risks. For example, a person may be known to be a fall risk because they have recently been under general anesthesia, a risk factor that can unquestionably result in increased fall risk. However, individuals tend to react differently to anesthesia, and, therefore, it can be difficult to assess when a person's likelihood of fall has decreased to an acceptable level as the anesthesia wears off which can result in a miscalculation of fall risk.
Because of these problems, assessment of fall risk tends to result in multiple problems in the hospital setting. The first of these is that the likelihood of fall is often greatly over calculated forcing those without any real risk to have to be in wheelchairs, or confined to bed, when there is no need for it. A second problem is that actual falls have been found to only be reduced by a mere 20% using current methods. Part of the reason for such problems is that the calculations of fall risk are often not quick to perform and are subjective as discussed above.
It can be difficult to determine a person's fall risk, for example, shortly after they arrive at the institution as they may not have had the chance to answer survey questions (or may be unable to, for example due to a language harrier) and personnel may not have had a chance to observe them. Further, even if fall risk can be determined relatively quickly, general condemnation of falls can still result in hospitals taking overly restrictive corrective measures in the first instance. These themselves can cause those who think they are being improperly confined to take risks they should not because they see the system as being overly inclusive.